Our Summary

This research paper discusses a study that looked at whether doing two specific surgical procedures at the same time - removing the pancreas (pancreatectomy) and part of the colon (colectomy) - increases the risk of complications and death. The study included patients who had these surgeries between 2006 and 2015 at a single medical center. The results showed that patients who had both the pancreas and part of the colon removed at the same time were more likely to experience complications and were more likely to die within 30 and 90 days following surgery. This was true regardless of the specific type of pancreatectomy performed, the original location of the disease (pancreas or colon), the reason for surgery (cancerous or non-cancerous), or whether the colectomy was planned ahead of time or decided during surgery. The study concludes that the addition of a colectomy to a pancreatectomy significantly increases the risks, and that patients should be informed of these risks. Further research is needed to identify ways to reduce these risks.

FAQs

  1. Does conducting a pancreatectomy and colectomy at the same time increase the risk of complications and death?
  2. Does the type of pancreatectomy or the original location of the disease influence the risk when both pancreas and part of the colon are removed?
  3. What steps should be taken to inform patients about the increased risks associated with adding a colectomy to a pancreatectomy?

Doctor’s Tip

A doctor might tell a patient undergoing a colectomy to carefully follow their post-operative care instructions, including taking prescribed medications, eating a healthy diet, staying hydrated, and avoiding strenuous activities. They may also recommend seeking support from a nutritionist or counselor to help with any dietary or emotional challenges that may arise after surgery. Additionally, patients should be vigilant for any signs of infection or complications and contact their healthcare provider immediately if they experience any concerning symptoms.

Suitable For

Patients who are typically recommended colectomy include those with:

  1. Colon cancer: Colectomy is often recommended as part of the treatment for colon cancer, especially if the cancer has spread to nearby tissues or organs.

  2. Inflammatory bowel disease (IBD): Patients with ulcerative colitis or Crohn’s disease may require colectomy if medications and other treatments are not effective in controlling their symptoms.

  3. Diverticulitis: Severe cases of diverticulitis, where the colon is inflamed or infected, may require colectomy to remove the affected portion of the colon.

  4. Colon polyps: Large or precancerous colon polyps may require colectomy to prevent the development of colorectal cancer.

  5. Familial adenomatous polyposis (FAP): Patients with FAP, a rare genetic condition that causes multiple colon polyps, may require colectomy to reduce the risk of developing colorectal cancer.

  6. Intestinal obstruction: Colectomy may be recommended to remove a blockage in the colon that is causing symptoms such as severe abdominal pain, bloating, and vomiting.

  7. Trauma or injury: In cases of severe colon trauma or injury, colectomy may be necessary to repair or remove damaged portions of the colon.

It is important for patients to discuss the potential risks and benefits of colectomy with their healthcare provider to determine if it is the best treatment option for their specific condition.

Timeline

Before colectomy:

  1. Patient is diagnosed with a condition that requires removal of part of the colon, such as colorectal cancer or inflammatory bowel disease.
  2. Patient undergoes preoperative testing and consultations with healthcare providers to prepare for surgery.
  3. Patient may need to follow a special diet or take medications to prepare for surgery.
  4. Patient undergoes the colectomy surgery, which can be done laparoscopically or through open surgery.
  5. After surgery, patient may need to stay in the hospital for several days to recover before being discharged.

After colectomy:

  1. Patient may experience pain, fatigue, and discomfort in the days and weeks following surgery.
  2. Patient will need to follow a specific diet and gradually reintroduce solid foods.
  3. Patient may need to take pain medications and antibiotics to manage pain and prevent infection.
  4. Patient will need to attend follow-up appointments with healthcare providers to monitor their recovery and address any complications.
  5. Patient may need to undergo physical therapy or rehabilitation to regain strength and mobility.
  6. Over time, patient will adjust to life with a partial colon and may need to make changes to their diet and lifestyle to manage any side effects or complications of the surgery.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with having a colectomy done in conjunction with a pancreatectomy?
  2. How will having both surgeries at the same time affect my recovery time and overall outcome?
  3. Are there any alternative treatment options to consider that may lower the risk of complications?
  4. What is the success rate for patients who undergo both surgeries simultaneously?
  5. How experienced are you in performing both a pancreatectomy and a colectomy together?
  6. What is the typical recovery process like for patients who have both surgeries done at the same time?
  7. Are there any specific factors about my health or medical history that may increase the risks of having both surgeries simultaneously?
  8. How will having both surgeries affect my long-term quality of life and potential complications in the future?
  9. What steps can be taken to minimize the risks associated with having a colectomy along with a pancreatectomy?
  10. Can you provide any additional information or resources for me to better understand the potential risks and benefits of having both surgeries done at the same time?

Reference

Authors: Schwartz PB, Roch AM, Han JS, Vaicius AV, Lancaster WP, Kilbane EM, House MG, Zyromski NJ, Schmidt CM, Nakeeb A, Ceppa EP. Journal: Surg Endosc. 2018 Jan;32(1):428-435. doi: 10.1007/s00464-017-5700-0. Epub 2017 Jun 29. PMID: 28664444